We propose to train nurse investigators in nursing outcomes research through a formal interdisciplinary program of predoctoral and postdoctoral study comprising the conceptual and empirical foundations and the methodologic approaches and statistical tools of advanced outcomes research. This training program bring together two distinguished programs of outcomes research at Penn--the Center for Health Services and Policy Research (Aiken/Sochalski) and the Center for Urban Health Research (Jemmott)--that will provide prospective trainees with the scholarly environment through which to examine the influence of both client- and system-focused strategies on patient and provider outcomes. In addition, this proposed training program in nursing outcomes research will directly interface with related predoctoral and postdoctoral training programs at Penn, providing a network of training opportunities for candidates that will augment those experiences offered through the School of Nursing. The program is founded on nursing's conception of the relationships between systems, clients, and outcomes depicted in the Quality Health Outcomes Model developed by the American Academy of Nursing's Expert Panel on Quality Health Care, and has as its goal the development of a cadre nurse researchers whose work will advance nursing science through rigorous testing and validation of the conceptual model for nursing outcomes research. The training program will accommodate three predoctoral and two postdoctoral fellows in the first year, and six predoctoral and four postdoctoral trainees in subsequent years. The program provides for the full complement of skills and experience in research grant submission and peer-reviewed data-based publications.